Prognosis in spinal cord injury, with special reference to patients with motor paralysis and sensory preservation.

Abstract

T RAUMA tO the spinal cord, particularly to the cervical spinal cord, almost invariably results in serious neurologic deficit. I t has been considered axiomatic tha t following injury to the cord above the level of the eonus medullaris, patients with complete motor and sensory paralysis will not recover. Over the years, however, certain patients with so-called concussion to the spinal cord, with a brief motor and sensory paralysis and rapid recovery over a few hours, have been known to recover completely. Between these two extremes lies a large group of patients for whom some hope of recovery may exist. Statistical studies ~-4.6.7 have been made concerning the percentages and degrees of recovery from paraplegia and tetraplegia. No correlation, however, has been made between the physical findings at the time immediately after injury and the degree of recovery. As early as 1887 Thorburn ~ noted recovery in some patients in whom a small amount of motor function was preserved in the legs. Taylor and Gleave TM reported excellent recovery in cases of incomplete injury of the spinal cord with Brown-S6quard phenomena. Schneider s'9 reported cases of spinal cord injury in which there was complete motor loss with preservation of sensation immediately after injury. Good recovery was seen. Occasional sporadic cases of complete motor loss and sensory preservation have been reported by others. ~